Sometimes a surgeon may desire to remove an intracorporeal tissue. For example, a surgeon may desire to surgically remove a diseased uterus or a tumor. It is common for a surgeon to access an intracorporeal tissue via a surgical incision made through skin of a patient. It is desirable to minimize an incision size for accessing the tissue. For example, minimizing the incision size aids in reducing patient recovery time, postoperative pain, risk of infection, potential damage to surrounding organs and tissues (e.g. an incisional hernia), and blood loss. As such, minimally invasive surgery (MIS) methods may be chosen for removing diseased intracorporeal tissue.
MIS may include laparoscopic procedures that allow a surgeon to remotely operate on an intracorporeal tissue through a small incision. For example laparoscopic surgery may include operating on an intracorporeal tissue via one or two small incisions, where the target intracorporeal tissue is under direct visualization provided by remote imaging such as ultrasound or fluoroscopy imaging, or various microscopes or endoscopes.
However, it is challenging to remove intracorporeal tissue via a small incision when the subject intracorporeal tissue is much larger than an incision size for extracting the tissue. For example, uterine extraction of larger uteri through a small incision may be difficult, if not impossible. As such, it is desirable to first segment or fragment larger tissues such that smaller segments may be removed through a small incision. Such segmenting of a target tissue is known in the art as morcellation.
Various conventional methods and devices exist for providing intracorporeal tissue morcellation. For example, one common morcellation method includes manually morcellating a target intracorporeal tissue via a scalpel, scissors, or electrosurgical blade, and removing morcellated particles through a small incision via forceps or an appropriate aspirating device. Another common method includes morcellating a target intracorporeal tissue via an electromechanical morcellation (EMM) device (i.e. an electromechanical morcellator or power morcellator). Current EMM devices usually include rotating blades or cutting edges that core, peel, fragment, mince or grind a target tissue. Further, current EMM devices may include an aspirating mechanism for aspirating paste-like or fragmented tissue that result from morcellation.
However, current morcellation methods and devices have various problems. Sometimes, a target tissue may be malignant. For example, a target tissue may be a sarcoma that mimics benign myomas on preoperative imaging or screening. Morcellation of a malignant tissue may spread malignancy to other areas of a patient's body. For example, morcellating a uterine fibroid may cause malignancy or uterine fragments to spread to abdominal organs or intraperitoneal space. Current morcellation methods and devices may cause accidental morcellation of non-target tissues, which may cause severe and fatal injuries. Fatalities or severe injury from common EMM methods and devices are well known in the art, and some hospitals have banned practice of such EMM procedures. Further, current morcellation methods and devices may leave behind unretrieved or un-aspirated tissue, which may cause long term tissue fragment or malignancy dissemination. Even further, current morcellation methods and devices may morcellate a target tissue and hinder postoperative histopathological evaluation of morcellated tissue. For example, common EMM devices may grind a target tissue into a paste-like consistency, which may reduce accuracy of histopathological evaluation of the target tissue.
One solution has been implemented to solve some of the above described problems. For example, contained tissue extraction (CTE) methods may include morcellating an intracorporeal tissue inside an impermeable bag or pouch, such that target intracorporeal tissue fragments are contained in the bag, preventing undesired fragment or malignancy dissemination. However, accidentally puncturing the bag via a scalpel or EMM device during such a contained tissue extraction method still may cause tissue fragment dissemination. Further, an EMM device may still hinder postoperative histopathological evaluation of morcellated tissue. Even further, EMM devices are expensive, and surgeons or patients in less-developed countries may not be able to afford EMM methods. However, manual methods via scissors or scalpels can still puncture such contained tissue extraction bags and damage surrounding tissues or spread diseased tissue fragments.
Therefore, there exists a need for a contained tissue extraction device and method that morcellates intracorporeal tissues without causing tissue fragment dissemination or undesired damage to adjacent tissues, and extraction of large enough specimen fragments for accurate histopathological evaluation of extracted tissue.